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Long-term survival analysis of total hip replacement
S J Birtwistle1, K Wilson, M L Porter
1Department of Orthopaedics, Royal Preston Hospital, Lancashire.
Summary
The cemented Charnley total hip replacement shows a 96% survival rate at 10 years, offering excellent long-term outcomes. Deep postoperative infection was the most frequent reason for revision surgery in this study.
Area of Science:
- Orthopaedic Surgery
- Biomaterials Science
- Clinical Outcomes Research
Background:
- Total hip replacement (THR) is a common procedure for hip osteoarthritis.
- The Charnley prosthesis is a widely used cemented hip implant.
- Evaluating long-term outcomes in general orthopaedic practice is crucial.
Purpose of the Study:
- To review the outcomes of primary cemented Charnley total hip replacements.
- To assess the survival rates and reasons for revision in a large patient cohort.
- To evaluate the efficacy of this implant in the hands of general orthopaedic surgeons.
Main Methods:
- Retrospective review of 1555 primary total hip replacements in 1375 patients.
- Analysis using standard life table methods.
- Data collection on revision surgeries, reasons for revision, and perioperative mortality.
Main Results:
- 10-year survival rate of 96%, comparable to specialist unit results.
- 35 patients (2.25%) required revision surgery.
- Deep postoperative infection was the primary indication for revision (most common reason).
- Perioperative mortality was 2%, with fatal pulmonary emboli in 0.25% of patients.
Conclusions:
- The cemented Charnley total hip replacement provides excellent long-term results.
- Its continued use is recommended for general orthopaedic surgeons.
- Surveillance for deep postoperative infection is critical for improving outcomes.